Automated device programming at changeout

ABSTRACT

This document discusses, among other things, methods and systems for facilitating automated device programming at changeout. A method comprises receiving, from a first device, physiological data at a temporary storage device; and processing the received physiological data, wherein the processing includes determining if a first signal processing function was used by the first device and substantially offsetting the first signal processing function if the first signal processing function was used by the first device; and processing the resultant physiological data to be compatible with a second device. The method further comprising providing the processed resultant physiological data to the second device.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a Continuation of U.S. application Ser. No.12/839,913, filed on Jul. 20, 2010, which is a Divisional of U.S.application Ser. No. 11/427,407, filed on Jun. 29, 2006, now issued asU.S. Pat. No. 7,783,356, the benefit of priority of each of which isclaimed herein, and which is incorporated herein by reference in itsrespective entirety.

TECHNICAL FIELD

This patent document pertains generally to implantable medical devices,and more particularly, but not by way of limitation, to automated deviceprogramming at changeout.

BACKGROUND

Implantable medical devices (IMDs), including cardiac rhythm managementdevices such as pacemakers, implantable cardioverter defibrillators, andcardiac resynchronization therapy devices, typically have the capabilityto communicate data with an external device, such as an externalprogrammer, via a telemetry link. While an external programmer istypically provided to program and modify the operating parameters of anIMD, modern IMDs also include the capability for bidirectionalcommunication so that information, such as physiological data, can betransmitted to the programmer.

A typical expected lifespan of an implanted medical device may rangefrom months to years. When an IMD reaches the end of its lifespan orwhen other events occur, such as a malfunction or defect that renders anIMD incapable of performing properly, the IMD is explanted and, in somecases, a new IMD is implanted to continue patient therapy.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, which are not necessarily drawn to scale, like numeralsdescribe substantially similar components throughout the several views.Like numerals having different letter suffixes represent differentinstances of substantially similar components. The drawings illustrategenerally, by way of example, but not by way of limitation, variousembodiments discussed in the present document.

FIG. 1 is a schematic view illustrating portions of a system thatenables physician-patient communication.

FIG. 2 is a dataflow diagram illustrating portions of a system capableof automatic data transfer.

FIG. 3 is a flowchart illustrating a method for transferring data.

FIGS. 4-7 are flowcharts illustrating a method for processing data fortransfer to a target device.

FIG. 8 is a diagram illustrating an implementation using multiplefunctions in serial on acquired data.

FIG. 9 is a diagram illustrating an implementation using multiplefunctions varying over time on acquired data.

FIG. 10 is a schematic diagram illustrating an external transfer devicecapable of transforming data and transferring the transformed data toanother device.

FIG. 11 is a schematic diagram illustrating another example of anexternal transfer device capable of transforming data and transferringthe transformed data to another device.

FIG. 12 is a schematic diagram illustrating another configuration totransfer and transform data from one device to another device.

DETAILED DESCRIPTION

The following detailed description includes references to theaccompanying drawings, which form a part of the detailed description.The drawings show, by way of illustration, specific embodiments in whichthe invention may be practiced. These embodiments, which are alsoreferred to herein as “examples,” are described in enough detail toenable those skilled in the art to practice the invention. Theembodiments may be combined, other embodiments may be utilized, orstructural, logical and electrical changes may be made without departingfrom the scope of the present invention. The following detaileddescription is, therefore, not to be taken in a limiting sense, and thescope of the present invention is defined by the appended claims andtheir equivalents.

In this document, the terms “a” or “an” are used, as is common in patentdocuments, to include one or more than one. In this document, the term“or” is used to refer to a nonexclusive or, unless otherwise indicated.Furthermore, all publications, patents, and patent documents referred toin this document are incorporated by reference herein in their entirety,as though individually incorporated by reference. In the event ofinconsistent usages between this document and those documents soincorporated by reference, the usage in the incorporated reference(s)should be considered supplementary to that of this document; forirreconcilable inconsistencies, the usage in this document controls.

FIG. 1 is a schematic view illustrating portions of a system thatenables physician-patient communication. In the example of FIG. 1, apatient 100 is provided with an implantable medical device (IMD) 102.Examples of implantable medical devices include a pacemaker, animplantable cardioverter defibrillator (ICD), a cardiacresynchronization therapy pacemaker (CRT-P), a cardiac resynchronizationtherapy defibrillator (CRT-D), a neurostimulation device, a deep brainstimulation device, a cochlear implant or a retinal implant. In someexamples, the IMD 102 is capable of sensing physiological data andstoring such data for later communication. Examples of physiologicaldata include implantable electrograms, surface electrocardiograms, heartrate intervals (e.g., AA, VV, AV or VA intervals), electrogram templatesfor tachy discrimination, pressure (e.g., intracardiac or systemicpressure), oxygen saturation, activity, heart rate variability, heartsounds, impedance, respiration, intrinsic amplitude, or the like. TheIMD 102 is capable of bidirectional communication with an externaltransceiver 104. In various examples, the IMD 102 receives commands fromthe transceiver 104 and may also communicate one or more patientindications to the transceiver 104. Patient indications may include suchthings as heart rate, heart rate variability, data related totachyarrhythmia episodes, hemodynamic stability, activity, therapyhistory, autonomic balance motor trends, electrogram templates for tachydiscrimination, heart rate variability trends or templates, or trends,templates, or abstractions derived from sensed physiological data. Inanother example, the IMD 102 may also communicate one or more deviceindications to the transceiver 104. Examples of device indicationsinclude lead/shock impedance, pacing amplitudes, pacing thresholds, orother device metrics. In other examples, the IMD 102 may communicatesensed physiological signal data to the transceiver 104, which may thencommunicate the signal data to a remote device for processing.Typically, the transceiver 104 is located in close proximity to thepatient 100. The transceiver 104 may be included within or attached to apersonal computer or a specialized device, such as a medical deviceprogrammer. In one example, the transceiver 104 is a hand-held devicethat is capable of connecting to a local computer 106. Typically, aconnection 105 can be made using a hard-wired connection (e.g., serial,USB, Firewire) or a wireless connection (e.g., RF, IR). In someexamples, the local computer 106 is a specialized device or a personalcomputer. In certain examples, the local computer 106 is adapted tocommunicate with a remote server system 108. The communication linkbetween the local computer 106 and the remote server system 108 istypically made through a computer or telecommunications network 110. Thenetwork 110 may include, in various examples, wired and wirelessnetworking such as the Internet, satellite telemetry, cellulartelemetry, microwave telemetry, or other long-range communicationnetworks. In some examples, the remote server system 108 comprises oneor more computers, such as a database server 114, a network server 116,a file server 118, an application server 120 and a web server 122. Incertain examples, one or more terminals 112A, 112B, . . . , 112N areconnected to the remote server system 108. The terminals 112 arecommunicatively coupled to the remote server system 108 using a wired124 or a wireless connection 126.

In some examples, the IMD 102 is adapted to store patient data and usethe data to provide tailored therapy. For example, using historicalphysiological data, an IMD 102 may be able to discriminate betweenlethal and non-lethal heart rhythms and deliver an appropriate therapy.However, it is often desirable to establish a proper baseline ofhistorical data by collecting a sufficient amount of data in the IMD102. In some examples, a “learning period” of some time (e.g., thirtydays) is used to establish the baseline for one or more physiologicalsignals. An IMD 102 may, in an example, store a moving window of data ofoperation, such as a time period equal to the learning period, and usethe information as a baseline indication of the patient's biorhythms orbiological events.

When an IMD 102 malfunctions or reaches the end of its lifecycle, a newIMD (not shown) may be implanted in place of the retired IMD 102. Insome examples, the replacement IMD is a newer or different model thanthe unit being replaced. In other examples, the replacement IMD issubstantially the same as the explanted IMD. The replacement IMD,however, generally does not have the benefit of the historical patientdata, and thus, the patient 100 must endure another learning period asthe new IMD builds its baseline. In addition, any patient-specificdevice settings stored on the explanted IMD 102 are typically notautomatically transferred to the replacement device. The currentinventor has recognized that providing historical patient data to areplacement IMD advantageously bypasses any necessary learning period.Additionally, the current inventor has recognized that automaticallytransferring device settings to a replacement IMD may be more efficientand less prone to human error.

FIG. 2 is a dataflow diagram illustrating portions of a system capableof automatic data transfer. A first patient device 200 is capable ofsensing a patient's physiological data and storing such data. In anexample, the first patient device 200 includes an IMD, such as oneillustrated in FIG. 1 at 102. In other examples, the first patientdevice 200 may be an external patient monitoring device, such as anelectrocardiograph machine, Holter monitor, blood pressure cuff, pulseoximeter, posture sensor, accelerometer, EEG monitor or respirationmonitor. Data 202 stored on the first patient device 200 is transferredto the external transfer device 204. In some examples, the data transferis enabled by wireless communication, such as inductive telemetry orradio frequency telemetry. In another example, the data transfer isperformed over a wired communication link, such as a serial connection.

Data 202 may include stored physiological data, calculated summary data,event data or device data. For example, an implantable medical devicemay sense and collect raw physiological data, temporarily store thephysiological data, use the data to calculate summary data, such astrend data, and store the trend data while discarding the temporarilystored raw physiological data. By only storing summary data, such astrend data, a more efficient use of the device's internal memory may beachieved. As another example, when an implanted medical device senses anevent, such as a tachyarrhythmia episode, the IMD may store eventmarkers or other details about the event (e.g., time of event, severity,length of event). Historical event data can be used for predictivelydetermining similar future events and adapting treatment accordingly.

In an example, the external transfer device 204 can temporarily storethe data 202 and process the stored data 202. For example, if the firstpatient device 200 is an IMD that is being explanted to be replaced withanother IMD 206, the external transfer device 204 may condition the data202 to be compatible with the replacement IMD 206. The conditioning may,in some examples, not involve any data transformation, such as when thefirst patient device 200 and the IMD 206 are substantially the samedevice. In other examples, the data conditioning may involve complexde-filtering and re-filtering of data, such as when the replacement IMD206 is a different model or has different capabilities than the firstpatient device 200. In another example, the conditioning may onlypartially transform the data, such as to an un-processed or raw, sensedform, and provide the data to the target device (e.g., the replacementIMD 206), which can treat it as sensed data and perform its own signalprocessing. In addition, data conditioning may involve a translation ofdevice settings, such as from one device model to another model withmore or fewer settings, or with settings that may be a combination orsubcombination of the other device's settings.

As another example, the external transfer device 204 may also providedata 202, either processed or unprocessed, to another destination, suchas a research laboratory 208 or a centralized patient management system210. Users at a research laboratory 208 may be interested in the data202 for several reasons including offline analysis or simulation. Inaddition, providing data 202 to a centralized patient management system210 may allow for other health care practitioners to access the data forresearch, statistical population use, patient monitoring, or for datarecovery purposes. In other examples, the external transfer device 204may also provide data 202, either processed or unprocessed, to anexternal patient monitor (not shown) or a data storage device (notshown).

FIG. 3 is a flowchart illustrating a method 300 for transferring data.At 302, one or more target devices are determined. Examples of targetdevices may include an external patient monitor, an implantable medicaldevice, or a data storage device (e.g., a database associated with aresearch laboratory or a centralized patient management system). At 304,the method 300 determines if the target device is the substantially thesame as the source device. For example, if a source device, such as anIMD, malfunctions or is defective, a same or similar device may be usedto replace the defective unit. The replacement device may have many, ifnot all, of the same signal processing or other capabilities andfeatures. As such, no data transformation is needed and at 306, the datacan be transferred to the target device with little or no dataprocessing. However, if the target device is different, such as may bethe case when an IMD is upgraded or if the data is transmitted to anexternal system for other uses, depending on the data transmitted,certain processing may be needed to transform the data into a formcompatible with the target device.

At 308, the data is processed. In an example, at 308 the data isprocessed to a format compatible with the target device before beingtransferred (block 306). In another example, the data is processed to asubstantially unprocessed (e.g., sensed) format at 308. Then thesubstantially unprocessed data is transferred to the target device(block 306) where the data is processed by the target device, such thatit is substantially similar to the target device's native format. At310, the method 300 determines if the data is to be transferred toanother device. If so, then the method 300 proceeds to decision block304 to continue processing.

FIG. 4 is a flowchart illustrating a method 308 for processing data fortransfer to a target device. At 400, the method 308 accesses a sourcedevice's device settings. Device settings may include such things as atachy rate zone, a brady pacing mode, one or more thresholds of tachydiscrimination algorithms, a tachy therapy parameter, a morphologicaltemplate, a brady therapy parameter, one or more thresholds of heartfailure decompensation detection algorithms, one or more thresholds ofapnea detection algorithms, a patient name, a patient gender, a patientbirth date, a patient height, a patient weight, a patient New York HeartAssociation class, a patient left ventricular ejection fraction, aphysician contact information or other settings, preferences, options,or threshold values that may be stored on a device to control itsoperation. At 402, the source device settings are stored in local memoryin an intermediary transfer device. At 404, the source device settingsare reconfigured, if necessary, to be compatible with a target device.

FIG. 5 is a flowchart illustrating a method 308 for processing data fortransfer to a target device. At 500, the method 308 accessesphysiological data. In an example, the physiological data is provideddirectly by the source device. In another example, the physiologicaldata is accessed from a storage device, such as a memory stick or a harddrive, which contains some of all of the physiological data collected bythe source device.

At 502, the method 308 determines if the data was processed by thesource device. In an example, a lookup table is used to record and trackwhich signals are modified or processed on which devices in which modes.Also, an indication of how the signals were modified or processed isrecorded in the lookup table for later reference when determining how toinvert or revert such processing. For example, the source device maycollect raw signal data and then process it, such as with a signalprocessing function, and only store the processed signal data. Signalprocessing functions may include a frequency-selective function, anupsampling function, a downsampling function, a re-sampling function, afiltering function, an amplifying function, an attenuating function, anaveraging function, a function to calculate the median, mode, standarddeviation or quartiles, a function to build a histogram, a function toestimate a probability distribution function or cumulative distributionfunction or a compressing function in various examples. Alternatively,the source device may store the raw or lesser-processed sensed signaldata either alone or in combination with more-processed data. In anexample, if both a lesser-processed signal data set and a more-processedsignal data set are available, the method 308 can attempt to de-processthe lesser-processed signal data first. This may advantageously avoidintroducing artifacts when trying to reverse the additional processingundergone by the more-processed signal data set.

At 504, if the signal data was initially processed by the source device,then the data is at least partially de-processed, such as tosubstantially revert to the original signal data format. For example, asource IMD may sense electrocardiogram data and use a first filterfunction H₁ to filter the incoming signal to remove noise and provide acleaner signal to analyze. In order to de-process or substantiallyrevert the data toward the original signal form, the method 308 mayapply an inverse filter function

H⁻¹ ^(′) ₁, where “′” indicates that H⁻¹ ^(′) ₁ is an estimate of aninverse function of H₁, as an exact inverse function may not be possibledue to mathematical limitations or limitations of physics. In someexamples, the first filter function H₁ is a linear determined 1:1process and thus, an actual inverse filter function H⁻¹ ₁ can berealized and implemented such that H⁻¹ ^(′) ₁=H⁻¹ ₁ and the resultingsignal has no distortion. In examples, the inverse filter function H⁻¹^(′) ₁ is applied in a time domain or a frequency domain. In a furtherexample, the inverse filter function H⁻¹ ^(′) ₁ includes anamplitude-modification function. For example, a first IMD may provide8-bit data storage whereas a second IMD may provide 12-bit data storage.To properly transform binary data from the first IMD's format to thesecond IMD's format, a left shift of 4 bits is used, which willappropriately scale the binary data to the second IMD's native format.As another example, if an input signal was subjected to automatic gaincontrol or intentional gain compression (e.g., non-linear gain) at afirst IMD, to compensate, one or more functions may be used to reversethe first IMD's transfer function to produce substantially un-processeddata.

In a further example, either the actual inverse filter function H⁻¹ ₁ orthe estimated inverse filter function H⁻¹ ^(′) ₁ may be determined basedon population data of patients with the same or similar devices, or withdevices that implement the same acquisition filter function H₁. In suchan example, the inverse filter function (e.g., H⁻¹ ₁, H⁻¹ ^(′) ₁) can beapproximated using methods such as adaptive filtering or using a neuralnetwork, which seek to minimize signal distortion until, for example,the distortion meets a “minimum distortion” criteria or threshold. Ingeneral, a population-based derivation method may be helpful in thecases where it is difficult or computationally expensive to directlyderive H⁻¹ ₁ from H₁ or when a derivation results in unacceptabledistortion.

In an example, the inverse filter function H⁻¹ ^(′) ₁ is designed suchthat a comparison between the reconstructed signal and the original rawsignal indicate minimal distortion. For example, the inverse filterfunction H⁻¹ ^(′) ₁ is designed to minimize one or more of a meansquared error, a minimum phase shift, a minimum dominant frequencycomponent deterioration, a reserved signal-to-noise ratio, or a highcross-correlation between the raw and the reconstructed signal data.

Similarly, if multiple signal processing functions were used during dataacquisition, then one or more other signal processing functions can bereversed by applying one or more other corresponding inverse or reversesignal processing functions.

Using either an analytical or a data-driven (e.g., population-based)method a maximum error or distortion in signal magnitude or phaseintroduced by H⁻¹ ^(′) ₁ can be determined. The maximum error may beused to indicate quantitatively how good the estimate H⁻¹ ^(′) ₁ is.Using the quantitative value as an “error bound” of the reconstructedsignal, the rate of false detection (due to magnitude distortion) and/orthe timing error of the detected event (due to phase distortion) may bedetermined and used to adjust discrimination processes when detecting anevent.

At 506, a target device is determined. The target device may include asecond (replacement) IMD, a workstation in a research computer system ora database in a centralized patient management system. In addition, thetarget device may be an offline storage device or a simulation oranalysis machine.

At 508, the physiological data is transformed to the target device'sformat. For example, the target may be an IMD that uses its own signalprocessing function H₂ . In order to transform the physiological dataobtained from the source IMD to simulate data captured on the targetIMD, an associated function H′₂ can be used. Again, the “′” indicatesthat H′₂ is an estimate of H₂, as it may not be possible to recreate H₂exactly due to mathematical limitations or limitations of physics. Insome examples, H₂=H′₂, such that the function used to transform or makethe data compatible with the target device is the same as that used bythe target device during its own data acquisition process. In otherexamples, a different function or group of functions may be used toprepare the data for the target device.

FIG. 6 is a flowchart illustrating a method 308 for processing data fortransfer to a target device. At 600, the method 308 accessesphysiological data. At 602, the method 308 determines if the data wasprocessed by the source device. Processes and methods used to access anddetermine if the data was processed by the source device aresubstantially similar to those described above (500 and 502 in FIG. 5).

At 604, if the signal data was initially processed by the source device,then the data is at least partially de-processed, such as tosubstantially revert to the original signal data format. For example, asource IMD may sense electrocardiogram data and use a first filterfunction H₁ to filter the incoming signal to remove noise and provide acleaner signal to analyze. In order to de-process or substantiallyrevert the data toward the original signal form, the method 308 mayapply an inverse filter function H⁻¹ ^(′) ₁, where “′” indicates thatH⁻¹ ^(′) ₁ is an estimate of an inverse function of H₁, as an exactinverse function may not be possible due to mathematical limitations orlimitations of physics. As described above with reference to FIG. 5, theinverse filter function H⁻¹ ₁ may appear in one or more forms, such asan actual inverse filter function H⁻¹ ₁, applied in a time domain or afrequency domain, implemented as an amplitude-modification function,determined with population data or a neural network, or designed tominimize distortion using one or more error metrics. Similarly, ifmultiple signal processing functions were used during data acquisition,then one or more other signal processing functions can be reversed byapplying one or more other corresponding inverse or reverse signalprocessing functions.

At 606, a target device is determined. The target device may include asecond (replacement) IMD, a workstation in a research computer system ora database in a centralized patient management system. In addition, thetarget device may be an offline storage device or a simulation oranalysis machine. In an example, the reverted (e.g., substantiallyunprocessed) data is provided to the determined target device, which mayuse its native signal processing functions to process the data.

FIG. 7 is a flowchart illustrating a method 308 for processing data fortransfer to a target device. At 700, the method 308 access physiologicaldata associated with a source device. In one example, the source devicemay collect physiological data and store it in internal memory. Inanother example, the source device may only store a portion of thecollected data and transfer other data to a separate device. Forexample, a source device (e.g., an IMD) may store a moving window ofdata and at periodic intervals (e.g., daily) transfer the oldest dataout of storage to make room for the next day's data acquisition. Thesource device may, for instance, transfer the historical data to a localstorage device (e.g., a personal computer) or a networked storage device(e.g., a network database) for archival storage.

At 702, the method 308 determines if the physiological data was modifiedduring acquisition by a first signal processing function. In someexamples, as the physiological data is acquired at a source device, thefirst signal processing function includes a first filter to clean andprepare the data for analysis. If the physiological data was modified bysignal processing by the source device, then the method 308 determinesthe function that was used.

In an example, more than one function may be used to process acquireddata at the source device. In some examples, the functions may beapplied serially. For example, the source device may sample, buffer,amplify, filter, upsample, downsample, or perform analog-to-digitalconversion on an intrinsic cardiac signal. In other examples, one ormore functions may be applied at different times during signalacquisition.

FIG. 8 is a diagram illustrating an implementation using multiplefunctions in serial on acquired data. In the dataflow diagram 800,sensed data 802 is acquired and stored in the source device. A firstfunction 804A is applied to the data, followed by one or more additionalfunctions 804B . . . 804N, where the result is processed data 806, whichmay be stored and used by the source device during its operation.

FIG. 9 is a diagram illustrating an implementation using multiplefunctions varying over time on acquired data. In the timeline diagram900, data captured by the source device during a first time period 902Ais processed by a first function 904A. As time progresses, at a secondtime period 902B, a second function 904B is used, and at an Nth timeperiod 902N, an Nth function 904N is used. Such different functions mayresult, for example, from applying different programmable filterconstants during different time periods. In certain examples, a log ofthe device's history of filter constants or other programmable signalprocessing parameters is stored by the device. The log may be accessed,such as during transfer, so that the appropriate de-processing functioncan be applied to the physiological signal over time periods whendifferent signal processing functions were used.

Referring to FIG. 7 again, at 704, if the data was processed, then afirst signal processing function H₁ is determined.

At 706, an inverse signal processing function H⁻¹ ^(′) ₁ is determined.As discussed above, H⁻¹ ^(′) ₁ may be an actual inverse function or anestimated inverse function conforming to a minimum threshold level ofdistortion. In some examples, the inverse function may be a multi-stepprocess, such as involving multiple sequential functions tosubstantially reverse the processing effects of the source device'sacquisition process. In an example, when multiple sequential functionswere used during the data acquisition, a reverse sequence ofcorresponding inverse functions is determined.

At 708, the inverse function H⁻¹ ^(′) ₁ is applied to the physiologicaldata. In an example, more than one inverse function is needed to revertthe data to its raw form. For example, if the source device appliedthree filter functions in series to the raw sensed data, the temporarydevice would use one or more corresponding inverse filter functions toundo the processing. Similarly, if the source device's acquisitionprocessing involved first filtering and then down-sampling, then thetemporary device's recovery processing may involve first up-sampling andthen inverse-filtering.

At 710, a target device and an associated signal processing function H′₂are determined. For example, if the target device is a replacement IMD,a function H′₂ is determined such that the function will transform thereverted physiological data to a form that is substantially similar tothat of the target device's signal-processed format.

As described above, in order to transform the physiological dataobtained from the source IMD to simulate data captured on the targetIMD, an associated function H′₂ can be used. The “′” indicates that H′₂is an estimate of H₂, as it may not be possible to recreate H₂ exactlydue to mathematical limitations or limitations of physics. In someexamples, H₂=H′₂, such that the function used to transform or make thedata compatible with the target device is the same as that used by thetarget device during its own data acquisition process. In otherexamples, a different function or set of functions may be used toprepare the data for the target device.

At 712, the transformation function H′₂ is applied to the revertedphysiological data. In an example, more than one filter function is usedto transform the data to a compatible form.

FIG. 10 is a schematic diagram illustrating an external transfer device1000 capable of transforming data and transferring the transformed datato another device. In FIG. 10, a communication module 1004 accessesphysiological data on a source device 1002. The communication module1004 may communicate with the source device 1002 via a wired or wirelesscommunication link 1006. Examples of wired communication may includeserial or parallel cabled communication. Examples of wirelesscommunication may include inductive telemetry, short-range or long-rangeradio frequency telemetry, or infrared telemetry. Physiological datatransferred from the source device 1002 is stored in a memory module1008. Memory module 1008 may include flash memory, random access memory,hard drive storage, optical drive storage, or other computerized storagemechanisms. A reversion module 1010 accesses the stored physiologicaldata from the memory module 1008 and de-processes the data, such thatthe de-processed data is substantially in the same form as originalsensed data. The reversion module 1010 may store the resultant data inthe memory module 1008. The external transfer device 1000 may includeone or more data transform modules 1012A, 1012B, 1012C, . . . , 1012N.Each data transform module 1012 may be tailored for use with one or moretarget devices 1014A, 1014B, 1014C, . . . , 1014N. A data transformmodule 1012 can access the reverted physiological data in the memorymodule 1008, transform the physiological data to a compatible form for aparticular type of target device, and provide the resulting compatibledata to a target device 1014 of that particular type.

FIG. 11 is a schematic diagram illustrating another example of anexternal transfer device 1000 capable of transforming data andtransferring the transformed data to another device. Some or all of thefunctionality described in the example illustrated in FIG. 11 may existin the example illustrated in FIG. 10. In some examples, the externaltransfer device 1000 may partially or fully de-process physiologicaldata using the reversion module 1010. De-processed data can be providedto a first target device 1016, which can then transform thephysiological data to a compatible form. In an example, the first targetdevice 1016 is an IMD and de-processed signal data is processed in asimilar manner as sensed physiological data using the first targetdevice's native signal processing function.

De-processed data can also be provided to one or more intermediateprocessing devices 1018. The intermediate processing devices 1018 canthen transform the physiological data to be compatible with a secondtarget device 1020. The intermediate processing devices 1018 may processthe de-processed data serially or in parallel. After fully transformingthe data, the re-processed physiological data is transferred to thesecond target device 1020.

In some cases, de-processing is a multi-step process and the externaltransfer device 1000 can perform one or more steps and transfer thepartially de-processed data to a secondary processing device 1022, whichcan complete the de-processing. In other examples, two or more secondaryprocessing devices (not shown) can be used, either serially or inparallel, to further process the partially de-processed data receivedfrom the external transfer device 1000. Fully de-processed data can thenbe transferred to one or more tertiary processing devices 1024. Thetertiary processing devices 1024 can re-process the physiological datasuch that it is compatible with a third target device 1026.Alternatively, the third target device 1026 can receive the de-processedphysiological data from the secondary processing device 1024 to processinternally, such as with the same or similar signal processing functionused during data acquisition.

FIG. 12 is a schematic diagram illustrating another configuration totransfer and transform data from one device to another device. A firstIMD 1200 may communicate with an external programmer 1202 and transmitphysiological data, such as in the form of processed or unprocessedsignal data. The external programmer 1202 may process the data. However,in some examples, a temporary storage device 1204 is used to process thedata (e.g., de-process the data to a substantially unprocessed form andthen process the data to be compatible with the target device) and theexternal programmer 1202 merely acts as a conduit between the first IMD1200 and the temporary storage device 1204. The temporary storage devicemay include, in some examples, a memory stick (e.g., a flash memorydevice). In an example, the temporary storage device 1204 connects witha second IMD 1206 to transfer the transformed data to the second IMD1206.

It is to be understood that the above description is intended to beillustrative, and not restrictive. For example, the above-describedembodiments (and/or aspects thereof) may be used in combination witheach other. Many other embodiments will be apparent to those of skill inthe art upon reviewing the above description. The scope of the inventionshould, therefore, be determined with reference to the appended claims,along with the full scope of equivalents to which such claims areentitled. In the appended claims, the terms “including” and “in which”are used as the plain-English equivalents of the respective terms“comprising” and “wherein.” Also, in the following claims, the terms“including” and “comprising” are open-ended, that is, a system, device,article, or process that includes elements in addition to those listedafter such a term in a claim are still deemed to fall within the scopeof that claim. Moreover, in the following claims, the terms “first,”“second,” and “third,” etc. are used merely as labels, and are notintended to impose numerical requirements on their objects.

For the purposes of this specification, the term “machine-readablemedium” or “computer-readable medium” shall be taken to include anymedium which is capable of storing or encoding a sequence ofinstructions for execution by the machine and that cause the machine toperform any one of the methodologies of the inventive subject matter.The terms “machine-readable medium” or “computer-readable medium” shallaccordingly be taken to include, but not be limited to, solid-statememories, optical and magnetic disks, and carrier wave signals. Further,it will be appreciated that the software could be distributed acrossmultiple machines or storage media, which may include themachine-readable medium.

Method embodiments described herein may be computer-implemented. Someembodiments may include computer-readable media encoded with a computerprogram (e.g., software), which includes instructions operable to causean electronic device to perform methods of various embodiments. Asoftware implementation (or computer-implemented method) may includemicrocode, assembly language code, or a higher-level language code,which further may include computer readable instructions for performingvarious methods. The code may form portions of computer programproducts. Further, the code may be tangibly stored on one or morevolatile or non-volatile computer-readable media during execution or atother times. These computer-readable media may include, but are notlimited to, hard disks, removable magnetic disks, removable opticaldisks (e.g., compact disks and digital video disks), magnetic cassettes,memory cards or sticks, random access memories (RAMs), read onlymemories (ROMs), and the like.

The foregoing description of specific embodiments reveals the generalnature of the inventive subject matter sufficiently that others can, byapplying current knowledge, readily modify and/or adapt it for variousapplications without departing from the generic concept. Therefore, suchadaptations and modifications are within the meaning and range ofequivalents of the disclosed embodiments. The phraseology or terminologyemployed herein is for the purpose of description and not of limitation.Accordingly, the inventive subject matter embraces all suchalternatives, modifications, equivalents and variations as fall withinthe spirit and broad scope of the appended claims.

The Abstract is provided to comply with 37 C.F.R. §1.72(b), whichrequires that it allow the reader to quickly ascertain the nature of thetechnical disclosure. It is submitted with the understanding that itwill not be used to interpret or limit the scope or meaning of theclaims. Also, in the above Detailed Description, various features may begrouped together to streamline the disclosure. This should not beinterpreted as intending that an unclaimed disclosed feature isessential to any claim. Rather, inventive subject matter may lie in lessthan all features of a particular disclosed embodiment. Thus, thefollowing claims are hereby incorporated into the Detailed Description,with each claim standing on its own as a separate embodiment.

1. A system comprising: an ambulatory medical device, comprising: acommunications port, adapted to receive reverted physiological data froman external processing device, wherein the reverted physiological datawas produced by the external processing device by: receivingphysiological data from a first medical device, wherein thephysiological data was obtained from raw data by the first medicaldevice using a first signal processing function; and processing thereceived physiological data by applying a second signal processingfunction to the received physiological data, wherein the second signalprocessing function substantially reverses the first signal processingfunction to provide the reverted physiological data, and wherein thereverted physiological data is approximate to the raw data; and amemory, to store the received reverted physiological data; and aprocessor, to process the received reverted physiological data byapplying a third signal processing function to convert the receivedreverted physiological data to be compatible with a process executed onthe ambulatory medical device.
 2. The system of claim 1, wherein theexternal processing device includes an external programmer for animplantable medical device, and wherein at least one of the firstmedical device and the ambulatory medical device is an implantablemedical device.
 3. The system of claim 1, wherein the communicationsport is adapted to be connected to an external programmer, and whereinthe first medical device is an ambulatory medical device.
 4. The systemof claim 1, wherein the ambulatory medical device is an implantablemedical device.
 5. The system of claim 1, wherein the communicationsport includes a USB connector.
 6. The system of claim 1, wherein thereverted physiological data includes electrocardiogram data.
 7. Thesystem of claim 1, wherein the reverted physiological data is associatedwith a tachyarrhythmia episode.
 8. The system of claim 1, wherein thesecond signal processing function is calculated to minimize at least oneof a mean squared error, a minimum phase shift, a minimum dominantfrequency component deterioration, a reserved signal-to-noise ratio, ora high cross-correlation between sensed physiological data and theresultant physiological data.
 9. The system of claim 1, wherein at leastone of the first and second signal processing functions include at leastone of a frequency-selective function, an upsampling function, adownsampling function, a re-sampling function, a filtering function, anamplifying function, an attenuating function, an averaging function, afunction to calculate the median, mode, standard deviation or quartiles,a function to build a histogram, a function to estimate a probabilitydistribution function or cumulative distribution function, or acompressing function.
 10. The system of claim 1, wherein the externalprocessing device is adapted to apply the second signal processingfunction in a time domain.
 11. The system of claim 1, wherein theexternal processing device is adapted to apply the second signalprocessing function in a frequency domain.
 12. The system of claim 1,wherein the second signal processing function comprises a plurality ofsignal processing functions aggregated to substantially reverse theeffects of the first signal processing function on the raw data.
 13. Thesystem of claim 1, wherein the external processing device is adapted toreceive device settings associated with the first medical device, andwherein the external processing device is adapted to configure thedevice settings to be compatible with the ambulatory medical device. 14.The system of claim 13, wherein the ambulatory medical device is adaptedto receive the device settings from the external processing device viathe communications port and implement the device settings at theambulatory medical device.
 15. The system of claim 13, wherein thedevice settings include at least one of a tachy rate zone, a bradypacing mode, one or more thresholds of tachy discrimination algorithms,a tachy therapy parameter, a morphological template, a brady therapyparameter, one or more thresholds of heart failure decompensationdetection algorithms, one or more thresholds of apnea detectionalgorithms, a patient name, a patient gender, a patient birth date, apatient height, a patient weight, a patient New York Heart Associationclass, a patient left ventricular ejection fraction, or a physiciancontact information.
 16. A method comprising: receiving at an ambulatorymedical device, reverted physiological data from an external processingdevice, wherein the reverted physiological data was produced by theexternal processing device by: receiving physiological data from a firstmedical device, wherein the physiological data was obtained from rawdata by the first medical device using a first signal processingfunction; and processing the received physiological data by applying asecond signal processing function to the received physiological data,wherein the second signal processing function substantially reverses thefirst signal processing function to provide the reverted physiologicaldata, and wherein the reverted physiological data is approximate to theraw data; and storing the received reverted physiological data; andprocessing the received reverted physiological data by applying a thirdsignal processing function to convert the received revertedphysiological data to be compatible with a process executed on theambulatory medical device.
 17. The method of claim 16, comprising:receiving device settings from the external processing device; andimplementing the device settings at the ambulatory medical device;wherein the external processing device received device settingsassociated with the first medical device and configured the devicesettings to be compatible with the ambulatory medical device.
 18. Themethod of claim 16, wherein the reverted physiological data includeselectrocardiogram data.
 19. The method of claim 16, wherein the revertedphysiological data is associated with a tachyarrhythmia episode.
 20. Anambulatory medical device, comprising: a communications port, adapted toreceive reverted physiological data from an external processing device,wherein the reverted physiological data was produced by the externalprocessing device by: receiving physiological data from a first medicaldevice, wherein the physiological data was obtained from raw data by thefirst medical device using a first signal processing function; andprocessing the received physiological data by applying a second signalprocessing function to the received physiological data, wherein thesecond signal processing function substantially reverses the firstsignal processing function to provide the reverted physiological data,and wherein the reverted physiological data is approximate to the rawdata; and a memory, to store the received reverted physiological data;and means for processing the received reverted physiological data toconvert the received reverted physiological data to be compatible with aprocess executed on the ambulatory medical device.